Changes with Time in Cross-Sectional Areas of Leg Muscles in Early Stroke Rehabilitation Patients: Disuse Muscle Atrophy and Its Recovery.

Abstract

We investigated changes in cross-sectional areas of thigh and calf muscles measured by sequential CT scan. Subjects were 20 stroke patients, mean age 66.8 years-old, who were admitted within 14 days from the onset. 1) In bedridden group, who couldn't walk without assistance until discharge, the cross-sectional areas demonstrated progressive decrease in both paralytic and non-paralytic side. The ratios of the cross-sectional areas at the 2nd, 4th and 8th week to that of admission level were significantly lower; 79-86%, 69-79%, 62-72%, respectively. 2) In the moderately disabled group, who couldn't ambulate independently in the 2nd week, the ratios significantly decreased to 89-95% in the initial 2 weeks but recovered to 94-99% at 8th week. 3) Early walking group, who could walk independently in the 2nd week, could maintain the ratios of 96-100% in the 2nd week. Our results suggested that disuse muscle atrophy occurs even in patients in early stroke rehabilitation program. Although we can improve this with an intensive exercise program, it takes three times longer than the immobilization period. (Jpn J Rehabil Med 1997; 34: 129-133)-v Ž|: "-•Ç OEã 'ae14•a "úˆÈ "à (' †‰› 'l 'ae1.5•a "ú) ‚É "ü ‰@ ‚µ ‚½ •‰ "-"] '² ' † Š³ ŽÒ20•l ‚Ì ‰º Žˆ‹Ø Žˆ‹Ø 'f-Ê •Ï ‚ðCT‚ð-p ‚¢ ‚Ä OEo Žž "I ‚É OEv 'ª ‚µ ‚½. (1)•u 'S ‰î •• OEQ •v ‚Å "ü ‰@2•T OEã ‚Ì-¼ '¤ 'å 'Ú, ‰ 'f-Ê •Ï ‚Í, "ü ‰@ Žž ‚Ì79•`86%(-¼ '¤ 'å 'Ú, ‰º 'Ú Še •X ‚Ì •½ ‹Ï80%, 84%)‚AE-L ˆÓ ‚É OE¸•OE¸•-‚µ •T Žž ‚É69•`79%, 8•T Žž ‚É62•`72%‚Ü ‚ÅˆÞ‚ÅˆÞ •k ‚µ ‚½. (2)•u '• Šú •à •s Ž©-§ OEQ •v ‚Å ‚Í, 2•T Žž ‚ 96•`100%‚AE 'f-Ê •Ï ‚ðˆÛ‚ðˆÛ Ž• ‚µ ‚Ä ‚¢ ‚½. (3)-¼ OEQ ‚Ì •u ' † ŠÔ OEQ •v ‚Å ‚Í, 2•T Žž ‚É89•`95%‚AE-L ˆÓ •-‚µ ‚½ ‚ª, 8•T Žž ‚É ‚Í"ü ‰@ Žž ‚Ì94•`99%("ü ‰@ Žž ‚AE-L ˆÓ •· ‚È ‚µ)‚Ü ‚Å ‰ñ •oe ‚µ‚½. '• Šú ƒŠƒn ƒe •[ ƒV ƒ ‡ ƒ"Š³ ŽÒ ‚Å ‚à"p-p •« ‹ØˆÞ‹ØˆÞ •k ‚Í OE© ‚ç‚ê,-ƒ რ'¤ ‚Å ‚à•\ •ª ‚È OEP-û ‚É ‚ae ‚è‹Ø "ì 'å ‚ð ‚« ‚½ ‚· ‚ª, ‰ñ •oe ‚É ‚Í •à •s OEP-û ŠJ Žn ‚Ü ‚Å ‚Ì Šú ŠÔ ‚Ì3"{ ˆÈ •ã ‚Ì '· Šú ŠÔ ‚© ‚© ‚é ‚± ‚AE‚ª Ž¦ •´ ‚³ ‚ê ‚½. (‚è ƒnˆãƒnˆã Šw 1997; 34: 129-133) Key words: "] '² ' † (stroke), '• Šú ƒŠƒn ƒr ƒŠƒe •[ ƒV ƒ ‡ ƒ" (early rehabilitation), "p-p •« ‹ØˆÞ‹ØˆÞ •k (disuse muscle atrophy), CT ‚Í ‚ ¶ ‚ß ‚É ƒŠƒn ƒr ƒŠƒe •[ ƒV ƒ ‡ ƒ"(ˆÈ ‰º ƒŠƒn)‚ð Žó ‚¯ ‚Ä ‚¢ ‚é•Ð-ƒ რŠ³ ŽÒ ‚Ì "ñ-ƒ რ'¤ ‚É ‚¨‚¢‚¨‚¢ ‚Ä ‚à"p-p •« ‹ØˆÞ‹ØˆÞ •k ‚ª OE© ‚ç ‚ê ‚é1•`3)‚È‚Ç, ƒŠƒnˆãƒŠƒnˆã Šw ‚É ‚AE ‚è"p-p •« ‹ØˆÞ‹ØˆÞ •k ‚Í ‚« ‚í ‚ß ‚Ä